Alisa Vaughn
NPI #1093297400 in Belleville, Illinois
Provider Information
- NPI Number
- 1093297400
- Entity Type
- Individual
- Name
- Alisa Vaughn
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Technician, Other
- Enumeration Date
- Aug 31, 2018
- Last Updated
- Aug 31, 2018
Practice Location
- Address
- 9601 W MAIN ST
- City
- Belleville
- State
- Illinois
- ZIP Code
- 62223-1415
- Phone
- (618) 917-2251
Specialties & Taxonomy Codes
| Specialty |
|---|
| Technician, Other |
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